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Data from the American Heart Association's Get With the Guidelines program showed patients who have strokes outside of a hospital setting get better care and have better outcomes than those who have the attacks as inpatients, according to research presented at the Society of Hospital Medicine conference. Dr. Ethan Cumbler, program director of the National Stroke Association In-Hospital Stroke Quality Improvement Initiative, said in-hospital strokes should be reported to quality databases so "we can accurately understand the quality of care we are providing, identify gaps, and perform process improvement to close any discrepancies."

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A smartphone system developed in Brazil allows a team of stroke experts to remotely evaluate high-quality images and aid neurologists in treating acute stroke patients, according to a study presented at the World Stroke Congress. The inexpensive system, Join App, was evaluated for one year in Brazil and found to be comparable to the in-hospital work station staffed by a stroke neurologist and neuroradiologist.

A study linked teaching hospital status with lower rates of in-hospital mortality for cardiac arrest patients, researchers reported in the American Journal of Cardiology. "The differences in mortality disappeared after adjusting for in-hospital procedures, indicating that routine application of novel therapeutic methods in patients with CA in teaching hospitals could translate into improved survival outcomes," study authors said.

A Canadian study in JAMA Neurology found that 32% of patients who suffer in-hospital stroke were given brain imaging scans within two hours of symptom recognition, compared with 63% of patients who had a stroke outside the hospital. Only 29% of in-hospital stroke patients were given thrombolysis within 90 minutes of being diagnosed, while 72% of community-onset stroke patients received the same treatment in the same timeframe. The study was based on data from 973 in-hospital stroke patients and 28,837 community-onset stroke patients.

The number of cases of invasive methicillin-resistant Staphylococcus aureus infections in the U.S. decreased by 30,800 from 2005 to 2011. Data published in JAMA Internal Medicine showed that of the estimated 80,461 cases in 2011, 48,353 were health care-associated community-onset cases and 16,560 were community-onset. There was a 31.2% decline in all infection categories: 54.2% in hospital-onset infections, 27.7% in HACO infections and 5% in community-onset infections.

Health care experts writing in a Health Affairs blog proposed seven policy changes to improve health care quality, such as measuring outcomes instead of processes and making better use of performance measures to reduce quality deficiencies. The group said quality should be measured at the organizational, not clinician level, and one entity should get the job of defining, measuring and reporting standards for quality and cost data.